Traumatic rupture of hydatid cysts: a 12-year experience from an endemic region

J Trauma. 1999 Jan;46(1):164-7. doi: 10.1097/00005373-199901000-00028.


Background: Trauma as a cause of hydatid cyst rupture leads to various clinical sequelae. However, extensive data in the current literature regarding clinical presentation and management of such patients are lacking.

Methods: This article is a retrospective review of 16 patients with traumatic rupture of hydatid cysts treated at a university hospital in an endemic area.

Results: Falls (44%) were the most common cause of trauma. The ruptured cysts were located in the liver in 13 patients (81%), in the spleen in 2 patients, and in the lung in 1 patient. Computerized tomography had a sensitivity of 100% in demonstrating cyst rupture; whereas, ultrasonography had a sensitivity of 85%. Ten patients (62%) had rupture into the peritoneal cavity and 5 patients (31%) into the biliary tree. Five (31%) of the cysts were infected. Surgical procedures included introflexion (five patients), pericystectomy-choledochoduodenostomy (three patients), external drainage-choledochoduodenostomy (two patients), unroofing-external drainage (two patients), splenectomy (two patients), unroofing (one patient), and right hepatectomy (one patient). Mean length of hospitalization was 15.9 days (range, 5-61 days). One patient (6%) died, and eight patients (50%) developed complications. Nine patients (56%) were followed-up for an average of 30 months (range, 3-72 months), and there was no recurrence.

Conclusion: Computed tomography is currently the most sensitive diagnostic tool for demonstrating hydatid cyst rupture. The surgical options vary depending on intraoperative findings. Allergic reactions and recurrence as a result of intraperitoneal spillage are not as common as once believed. Biliary rupture is associated with an increased rate of wound infection.

MeSH terms

  • Accidental Falls*
  • Adolescent
  • Adult
  • Child
  • Echinococcosis / diagnostic imaging*
  • Female
  • Humans
  • Liver / injuries
  • Liver / parasitology
  • Lung / parasitology
  • Lung Injury
  • Male
  • Medical Records
  • Middle Aged
  • Retrospective Studies
  • Rupture
  • Sensitivity and Specificity
  • Spleen / injuries
  • Spleen / parasitology
  • Tomography, X-Ray Computed
  • Ultrasonography